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经皮激光消融术与根治性肾输尿管切除术:肾盂肿瘤的对比研究

Percutaneous laser ablation vs. radical nephroureterectomy: a comparative study on renal pelvic tumors.

作者信息

Li Gao, Chen Yuanhao, Zhang Xin

机构信息

Department of Urology, Beijing Chao-Yang Hospital Affiliated to Capital Medical University, No. 5 Jing Yuan Road, Shi Jing Shan District, Beijing, 100043, China.

出版信息

Int Urol Nephrol. 2025 Jul;57(7):2127-2134. doi: 10.1007/s11255-025-04395-4. Epub 2025 Feb 4.

Abstract

PURPOSE

To compare the safety and efficacy of percutaneous laser ablation and radical nephroureterectomy for renal pelvic tumors.

METHODS

This prospective cohort study included 30 patients diagnosed with renal pelvic tumors who met the established selection criteria. The cohort was divided into two groups: Group I, consisting of 15 patients who underwent percutaneous laser ablation, and Group II, comprising 15 patients who received radical nephroureterectomy. Comprehensive data collection encompassed demographic information, intraoperative and postoperative outcomes, and disease-free survival.

RESULTS

The analysis revealed that percutaneous laser ablation offered modest benefits over radical nephroureterectomy in terms of reduced surgical duration (P < 0.01) and shorter hospital stays (P = 0.03). However, in evaluating long-term oncologic outcomes, percutaneous laser ablation did not achieve parity with radical nephroureterectomy. Although the differences in long-term outcomes were not statistically significant (HR: 0.48; 95% CI 0.05-4.92, P = 0.54), radical nephroureterectomy exhibited a slight advantage in disease-free survival.

CONCLUSION

Percutaneous laser ablation presents a safe and effective, less invasive treatment alternative, rendering it a feasible option for patients who are either unable or unwilling to undergo radical nephroureterectomy due to comorbid conditions or personal preferences.

摘要

目的

比较经皮激光消融术与根治性肾输尿管切除术治疗肾盂肿瘤的安全性和有效性。

方法

这项前瞻性队列研究纳入了30例被诊断为肾盂肿瘤且符合既定入选标准的患者。该队列分为两组:第一组由15例行经皮激光消融术的患者组成,第二组由15例行根治性肾输尿管切除术的患者组成。全面的数据收集包括人口统计学信息、术中和术后结果以及无病生存期。

结果

分析显示,经皮激光消融术在缩短手术时间(P < 0.01)和缩短住院时间(P = 0.03)方面比根治性肾输尿管切除术有一定优势。然而,在评估长期肿瘤学结果时,经皮激光消融术与根治性肾输尿管切除术未达到同等效果。尽管长期结果的差异无统计学意义(风险比:0.48;95%置信区间0.05 - 4.92,P = 0.54),但根治性肾输尿管切除术在无病生存期方面显示出轻微优势。

结论

经皮激光消融术是一种安全有效的、侵入性较小的治疗选择,对于因合并症或个人偏好而无法或不愿接受根治性肾输尿管切除术的患者而言,是一种可行的选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ddda/12167339/15d93a232fe3/11255_2025_4395_Fig1_HTML.jpg

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